Axid, Zantac vs something else

[Anonymous]

My 12 week old has been on Axid first then Zantac and now back to Axid for about 4 weeks now. The Axid worked at first, but then started not working. The Dr said that it was because he outgrew the dosage (weight). He was on .8 ml 2x a day, so he upped it to 1.2ml 2x a day. worked for a day, then started spitting up clear liquid. I asked if the medicine could be causing it so we decided to dial it back to 1.0ml. worked for a day and then back to the same thing. Had me switch to Zantac and said .7 – 1.0ml 2x a day. Start him out low and move up. When it got to be around .9/1.0, same thing again. He also started vomitting. Big difference from spit up and it smells like vomit too.

We have no issues with weight gain, he’s a hefty 16lbs and sleeps through the night 9-10 hours. His feedins are irregular time and oz and some times he keeps bottles down fine and other times he doesn’t. He does have cereal in his bottle (oatmeal) every other bottle. They wanted me to do it every bottle, but he was throwing up from being overfed when I tried it.

I’ve been reading some posts about compounded prevacid or Zegerid. I hate medicating my baby, but what am I to do? Any insight would be greatly appreciated. I just don’t like seeing him uncomfortable nor blowing chunks like he has been.

[hellbennt]

the medications don’t stop spit up or vomiting, they help with the pain

is your baby in pain?

[Anonymous]

I am by no means the expert, but we did start with Axid and it did nothing for my son, but he was in pain and plain refused all feeds and didn’t sleep.

It sounds like your son eats well and sleeps but just throws up a lot?? The medicine won’t change the throwing up. That is just something he will eventually grow out of when the sphincter muscle becomes stronger. The medicines just neutralize the acid so that when they are refluxing, it doesn’t hurt. IF YOU THINK HE IS IN PAIN, that’s a different story. You said the medicine worked at first but then quit working??? Does that mean he was in pain?? Then you should probably look into a PPI.

We had to change meds b/c my son was in so much pain he cried day and night and refused to breastfeed and refused a bottle and we got no sleep. The meds you are using are wt sensitive, Prevacid and some of the others that most people use on this board are not. Prevacid is hard to get compounded correctly, but a lot of people on here use Prevacid solutabs or Zegerid. I would deter from the compound, I am using it b/c my son doesn’t eat very much a time and the solutabs are to be followed up with a full feed 30-60 min after they are given. It took us 6 mo to find someone that compounded the meds correctly!

There are a lot of veteran posters on here and they will probably give you more guidence than I can! I know I certainly couldn’t live without them! They have saved my sanitiy!!!

Check out Marci-kids website, it is what most moms on here use for proper dosing and it explains in laymans terms a lot about reflux. Also, I think a lot of people have trouble getting a high enough dose for their child b/c doctors obviously start low……

I hope that someone else posts to you soon and hopefully corrects anything that I said that was incorrect!

Good luck and I hope you find relief soon!

[Anonymous]

Thank you for your input. We actually just came back from the Dr. The vomitting is not spitting up, but my Dr feels, as do I, it is a side effect reaction to this family of meds. On the lower end of the dosage it’s not enough to help him with the acid, but the upper end causes him to throw up. When he’s on the lower end, he doesn’t vomit so it is the medicine causing it.

He said that some children don’t react well to medicines like Axid or Zantac and my son appears to be one of them.

We have now moved on to the next family of meds and we are going to try compounded prevacid. So we are now going to try the prevacid to see what happens. There’s no pattern to his behavior. We have a good day with med and bottle and we do the same exact thing the next day and it’s a completely opposite thing. If he was spitting up alot without discomfort, I wouldn’t be as concerned, but again, he’s not uncomfortable ALL the time, but when he is, it is bad

The other thing we are stopping is the cereal in the bottle. It’s apparently complicating things as well as he’s 16lbs and 3 months old today 95th percentile. Nothing to be concerned about and it should level off if we can get some of this under control.

On top of that this morning, he had dry heaves. He had some bottle this morning and there was a little bit of a brown stringy substance in it. The Dr. thinks that it is a slight tear in the esophagus. Not OVERLY concerned about it now since it was a one time thing and there’s no progression to the vomit. If he vomitted often, then there would be an issue, but since the vomit only occurs when the dosage of the medicine is raised, then he feels comfortable saying that it’s the medicine.

Already a big difference from not giving him the medicine since yesterday. He will go the day with no medicine as the pharmacy preps the prevacid because they do it overnight.

That’s the latest and thank you again for all of your input. I will note the sites that you told me to go to and check them out.

Much blessings,

Maria

[Anonymous]

I’m happy to hear that you are going to try Prevacid. Most of us have much better luck with this type of drug (a PPI) rather than the H2 Blockers like Zantac and Axid. There’s one thing you should know though and that is that Prevacid is very difficult to compound so the compouned version often is made wrong and doesn’t work. Here’s a tread that talks about it. You may want to try the Solutabs, or take this info to the pharmacist and make sure he’s doing it exactly right.

There should be no flavorings whatsoever, there must be 16.8% sodium bicarb, and each dose must be at least 3.5 mls or there will not be enough buffer to protect the drug from degrading in the stomach. Also it should be refilled every two weeks, not monthly.

https://www.infantreflux.org/forum/forum_posts.asp?TID=4505&a mp;KW=pharmacy+compounded+

Good luck. I hope your little guy is feeling better soon.

[Anonymous]

just wanted to add that most compounds are made incorrectly 🙁 so they are unstable and so people think the medicine does not work….that link ndrose posted is great! i would show that to the pharmacy and ask that they humor you and make it just like that. from the people that i have met who had babies on PPI’s, most of them did not have luck with compounds because they were not being made correctly, yet when their babies switched to a different form of the med, they seemed much better.

[Anonymous]

I brought that information into the pharmacy and she never heard of it. They make it with 8.4% I think. They said they are following Children’s Memorial Recipe. They may not do it based on an email printout from me. The pharmacist comes on at 10pm who’s going to mix the compound. I told the Pharmacy manager I would call this evening. I’ll let you know tomorrow.

Maria

[Anonymous]

I re-read the post and it sounds like a zegerid commercial. They also say that a compounded ppi shouldn’t be given to infants, yet we should still request that it be made a certain way. Also, the article states don’t give less than 3.5ml, however I am supposed to start him out at 1.4ml 1/3 tsp and I can go as high as a 1/2 tsp but that’s it him being so young which is less than the 3.5ml. Should I even bother giving it to him.

I asked my Dr about the Zegerid, and he said that it was too new and wasn’t comfortable because he didn’t know what side effects it had.

Confused

[hellbennt]

ok, let me try & help with the confusion…

a compounded PPI is what should be given to infants bcse it’s liquid and it can be given at any time w/o regard to a full belly or an empty belly, etc. HOWEVER, compounding pharmacies almost always compound the PPIs so that they aren’t stable, which makes then ineffective…this has been proved from scientific research & marci-kids is at the forefront of this research (University of Missouri- dr phillips is a Pharm.D who is the leading researcher in this field). this (finding compounds to be unstable) has ALSO been ‘proved’ by plain ‘ole moms & dads from this site– if you go to ‘Prevacid 101′ (last post on the page): https://www.infantreflux.org/forum/forum_posts.asp?TID=1936&a mp;PN=0&TPN=1

you’ll see a link that I made to show past posts about parents on this very board figuring out about their compounds losing stability over time!

there used to be a product called Caracream and chocobase. these were the predescessors to Zegerid. If you go to Prevacid 101, you can read more about them. they are still available in limited amounts, again see prevacid 101. WE LOVED CARACREAM. then came zegerid which is made w/ prilosec (caracream/chocobase could be used w/ any PPI) and bcse it’s made with prilosec, there’s a noncompete clause so that caracream can’t be sold bcse it can be used w/ any PPI. not sure this makes sense to read? so now, the best thing to give to babies is zegerid because it’s a stable liquid way to give a PPI to a baby w/o having to time it according to feeding…HOWEVER, zegerid has it’s own issues as well as everything else– one beng that it’s w/ prilosec and some babies do better with prevacid…

SO: the next best thing is to ask the pharmacist to humour you & compound the PPI the way you ask her/him to. OR, you ask your dr to humour you & ask the dr to write out the prescription the way you want the pharmacy to compound it

the next thing is prevacid solutabs. these have worked wonderfully for many many babies!!!

I hope this helps some

[Anonymous]

if you give less than 3.5 ml of the compound at a time, there wont be enough buffer to protect the drug from degrading in the stomach. also, compounds are ideal, however most of the time pharmacists do make them correctly. its too bad that pharmacist wouldnt even consider looking at some new material. sounds a little close minded 🙁

[Anonymous]

The pharmacist looked at it and found it intresting. She did say that they use something different then the documentation said was the problem. It’s the recipe from hope Children’s hospital. We did go to the ER today because he vommitted twice this morning. Miscommunication on the dosage. We should be giving him 2.5ml per day so two of 1.25ml. They jumpstarted him on an iv of pepcid which is working wonders at the moment. Part of the problem is because he was vomitting so much, he wasn’t keeping the medicine down so this at least bypassed that and is doing well and we’ll continue on with the dosage of 2×1.25 of prevacid. We have a follow up with his Dr on Tues and then well see about going to a Gastro.

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